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General NPI Number Information
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NPI Number | 1396815650
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Entity Type | Individual
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Provider Name | JULIE ANN CIANCIOLA BEACH DDS,MS
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Gender | Female
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 368 ELMRIDGE CENTER DR
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City | ROCHESTER
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State | NY
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Zip | 14626-3461
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Country | US
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Telephone | 585-326-8431
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Fax | 585-486-3048
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Provider Business Mailing Address
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Address Line | 368 ELMRIDGE CENTER DR
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City | ROCHESTER
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State | NY
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Zip | 14626-3461
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Country | US
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Telephone | 585-326-8431
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Fax | 585-486-3048
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 047163
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License Number State | NY
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